Comparison of Results of Intramedullary Nailing with Plate Osteosynthesis in the Treatment of Fracture Shaft of Humerus

Dr Dhaval R. Modi; Dr Rukesh R. Patel; Dr Rushi R Solanki; Dr Manthan Mandalia; Dr Ankit Chaudhary

Volume : III, Issue : VIII, August - 2014

Comparison of Results of Intramedullary Nailing with Plate Osteosynthesis in the Treatment of Fracture Shaft of Humerus

Dr Dhaval R. Modi, Dr Rukesh R. Patel, Dr Rushi R Solanki, Dr Manthan Mandalia, Dr Ankit Chaudhary

Abstract :

• Aims : To compare the outcomes of intramedullary nails with plate osteosynthesis for the treatment of fracture shaft of humerus. • Introduction: Humerus is the single long bone of upper arm. There has been considerable controversy about the optimal mode of management for fracture of humerus shaft,as it can be treated both conservatively or operatively. Encouraging results with recent advances in internal fixation techniques and instrumentation have led to an expansion of surgical indications and a dilemma about the procedure of choice between nailing vs. plating. • Materials and methods: : We have done retrospective study of 30 patients with humerus shaft fractures with follow up of 12 to 20 months in which 14 cases were operated with plate osteosynthesis & 16 cases operated by intramedullary fixation by TEN nails. We included all acute shaft humerus closed as well as open grade-I &II fractures except 1.open grade-III ( Gustilo and Anderson fractures classification) 2.delayed union 3.Nonunion 4.fractures other than within 2 cm of surgical neck to 3 cm above olecrenon fossa . Final out comes were assesed according to ASES Score and results of platting and nailing compared. • Results: Fracture union:50% of patients treated with nails and 75% of patients treated with plates showed evidence of union on or before 16 weeks Functional Outcome: nail group and plating group had similar results at the final follow up. Superficial infection occurred in 2 patients treated with platting. • Conclusion: We conclude from the study that plating is the preferred method in the majority of fractures of the shaft of the humerus with better preservation of joint function and better stability of the fracture. The long term results of nailing is almost equal to plating, if done with proper technique and followed with early rehabilitation.